INCIDENCE, CLINICAL CHARACTERISTICS AND OUTCOMES OF EARLY HYPERBILIRUBINEMIA IN CRITICALLY ILL PATIENTS: INSIGHTS FROM THE MARS STUDY
Issued Date
2022-02-01
Resource Type
ISSN
10732322
eISSN
15400514
Scopus ID
2-s2.0-85123650862
Pubmed ID
34238904
Journal Title
Shock
Volume
57
Issue
2
Start Page
161
End Page
167
Rights Holder(s)
SCOPUS
Bibliographic Citation
Shock Vol.57 No.2 (2022) , 161-167
Suggested Citation
Juschten J. INCIDENCE, CLINICAL CHARACTERISTICS AND OUTCOMES OF EARLY HYPERBILIRUBINEMIA IN CRITICALLY ILL PATIENTS: INSIGHTS FROM THE MARS STUDY. Shock Vol.57 No.2 (2022) , 161-167. 167. doi:10.1097/SHK.0000000000001836 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/87381
Title
INCIDENCE, CLINICAL CHARACTERISTICS AND OUTCOMES OF EARLY HYPERBILIRUBINEMIA IN CRITICALLY ILL PATIENTS: INSIGHTS FROM THE MARS STUDY
Author(s)
Other Contributor(s)
Abstract
Objective: To investigate the incidence, clinical characteristics and outcomes of early hyperbilirubinemia in critically ill patients. Design and Setting: This is a post hoc analysis of a prospective multicenter cohort study. Patients: Patients with measured bilirubin levels within the first 2 days after ICU admission were eligible. Patients with liver cirrhosis were excluded. Endpoints: The primary endpoint was the incidence of early hyperbilirubinemia, defined as bilirubin ≥33 μmol/L within 2 days after ICU admission. Secondary endpoints included clinical characteristics of patients with versus patients without early hyperbilirubinemia, and outcomes up to day 30. Results: Of 4,836 patients, 559 (11.6%) patients had early hyperbilirubinemia. Compared to patients without early hyperbilirubinemia, patients with early hyperbilirubinemia presented with higher severity of illness scores, and higher incidences of sepsis and organ failure. After adjustment for confounding variables, early hyperbilirubinemia remained associated with mortality at day 30 (odds ratio, 1.31 [95%-confidence interval 1.06-1.60]; P = 0.018). Patients with early hyperbilirubinemia and thrombocytopenia (interaction P-value = 0.005) had a higher likelihood of death within 30 days (odds ratio, 2.61 [95%-confidence interval 2.08-3.27]; P < 0.001) than patients with early hyperbilirubinemia and a normal platelet count (odds ratio, 1.09 [95%-confidence interval 0.75-1.55]; P = 0.655). Conclusions: Early hyperbilirubinemia occurs frequently in the critically ill, and these patients present with higher disease severity and more often with sepsis and organ failures. Early hyperbilirubinemia has an association with mortality, albeit this association was only found in patients with concomitant thrombocytopenia.